摘要
目的通过核磁共振T2*加权梯度回波成像(MRI GRE-T2*WI)筛查脑微出血(CMB),探讨CMB与卒中发生、发展之间的关系,及其与卒中危险因素之间的联系。方法纳入脑血管病患者140例,其中腔隙性脑梗死组58例、脑梗死组42例,脑出血组40例;另收集同期30例住院或门诊非血管病患者作为对照组。登记所有患者血压、血脂、血糖、既往史等基线资料,行MRI GRE-T2*WI扫描,记录各组脑微出血发生例数、部位、数目,进行统计分析。结果所有170例患者中,CMB患者的血压、血脂、血糖等较无CMB患者高,症状明显,对比明确(P均<0.05);各脑卒中组的CMB发生率均明显高于对照组(P均<0.05);各脑卒中组CMB分级构成不同(P<0.05),脑出血组CMB重度发生率明显高于其它各组;有CMB的各脑卒中组CMB总体均数比较,自发性脑出血组>腔隙性脑梗死组>脑梗死组。结论高血压病、糖尿病、高脂血症是影响CMB发生的显著因素;CMB作为微出血病变,在预测脑出血病变方面具有一定意义,可通过对CMB的诊断了解脑部出血的部位等基本信息,为以后的治疗带来方便;MRI GRE-T2*WI扫描的诊断方法为脑出血病变的常规诊断方法,此种方法在诊断脑出血病变准确度高,优势明显,因此,对于临床的诊断治疗具有显著的价值,可推广。
Objective To screen cerebral microbleeds （CMB） by magnetic resonance gradient echo-T2 ＊ weighted imaging （MRI GRE-T2 ＊ WI） ,investigate the relationship between CMB, the incidence and development of stroke, research the connection between CMB and the risk factors of stroke. Methods 140 cases of patients with cerebrovascular disease were included,58 cases in lacunar infarction group,42 cases in cerebral infarction group and 40 cases in cerebral hemor- rhage group;and 30 cases of hospitalization or outpatient patients with non-cerebrovascular disease in the same period as a control group. Registrated the data of all patients with blood pressure, serum lipids, serum glucose, past bistmy and other baseline information, performed GRE-T2 ＊ WI, recorded NNT in each group of cerebral microbleeds, location, number, and all of the records were input to statistical analysis. Results In all of 170 patients,the presence of CMB in patients with hy- pertension, diabetes or hyperlipidemia was significantly higher than that of non-CMB group （P 〈 0.05 ） ;the CMB incidence of each stroke group was significantly higher than control group （P 〈 0.05 ） ; classification constitutes of CMB in each stroke group were different （ P 〈 0.05 ） , and the incidence of severe CMB in cerebral hemorrhage group was significantly higher than other groups ;comparing population mean of CMB in each stroke group, cerebral hemorrhage group 〉 lacunar infarction group 〉 cerebral infarction group. Conclusion Hypertension,diabetes,byperlipidemia are significant factors affecting CMB occurrance;CMB is closely related with stroke, especially hemorrhagic stroke,it has early predictive value to hemorrhagic transformation in stroke patients;Screening CMB by GRE-T2 ＊ WI routinely is important to patients with stroke in reducing the incidence of hemorrhagic stroke, improving therapeutic schedule and evaluating prognosis.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2014年第3期219-221,共3页
Journal of Apoplexy and Nervous Diseases
